The present invention relates to claims adjustment, worker's compensation claims and common law claims. Traditionally, an adjuster in a workers' compensation case receives a claimant's medical information from a physician, employer, hospital or other medical provider, assesses whether the claimant will be able to return to work and, if so, assesses how long the claimant will be out of work. Based on this assessment, the adjuster assesses the potential cost to the insurer and employer. A similar process occurs where the claim, or potential claim, arises outside a workers' compensation system. There, the adjuster assesses the potential liability under “common law” recovery systems. The adjuster's decisions are based on experience, available historical medical reference data and available historical liability data, as should be understood in this art.
The claimant data and medical data may include the claimant's name, age, sex, occupation, injuries, preexisting conditions, treatments, complications and prognoses. In workers' compensation cases, the adjuster considers the claimant's job requirements in light of the medical data to determine if and when the claimant will return to work. In common law cases,
the adjuster considers the claimant's medical conditions in light of historical liability data to assess the common law liability for those conditions.